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Drug Interactions between Diurex and levothyroxine

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

levothyroxine magnesium salicylate

Applies to: levothyroxine and Diurex (caffeine / magnesium salicylate)

Consumer information for this interaction is not currently available.

ADJUST DOSING INTERVAL: Concurrent administration of simethicone, sucralfate and/or antacid preparations may decrease the oral bioavailability of levothyroxine. Pharmacologic effects of levothyroxine may be reduced. The exact mechanism of interaction is unknown but may involve nonspecific adsorption of levothyroxine to polyvalent cations, resulting in an insoluble complex that is poorly absorbed from the gastrointestinal tract. Additionally, agents that affect intragastric pH may reduce levothyroxine absorption. There have been case reports suggesting decreased efficacy of levothyroxine during coadministration of aluminum- and magnesium-containing antacids, as well as other products containing polyvalent cations such as calcium and iron. In one report, a man stabilized on levothyroxine 150 mcg/day developed significantly increased serum thyrotropin (thyroid-stimulating hormone, or TSH) levels while taking an aluminum and magnesium hydroxide antacid. The apparent interaction was also observed on two subsequent rechallenges. Other case reports have described increased dosage requirements of levothyroxine during antacid use. It is not known whether this interaction occurs with other thyroid hormone preparations.

MANAGEMENT: It is recommended to separate the times of administration of thyroid replacement hormones and simethicone, sucralfate, antacids or other antacid-containing preparations (e.g., didanosine buffered tablets or pediatric oral solution) by at least 4 hours. Monitoring of serum TSH levels is recommended. Patients with gastrointestinal or malabsorption disorders may be at a greater risk of developing clinical or subclinical hypothyroidism due to this interaction.

Drug and food interactions

Moderate

levothyroxine food

Applies to: levothyroxine

The timing of meals relative to your oral levothyroxine dose can affect the absorption of the medication. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals to avoid large fluctuations in blood levels, which may alter its effects. In addition, absorption of levothyroxine may be decreased and/or delayed by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, calcium fortified juices and grapefruit or grapefruit juice. These foods should be avoided within several hours of dosing if possible. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

magnesium salicylate food

Applies to: Diurex (caffeine / magnesium salicylate)

Ask your doctor before using magnesium salicylate together with ethanol. Do not drink alcohol while taking magnesium salicylate. Alcohol can increase your risk of stomach bleeding caused by magnesium salicylate. Call your doctor at once if you have symptoms of bleeding in your stomach or intestines. This includes black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Moderate

levothyroxine food

Applies to: levothyroxine

Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine. You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

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Minor

caffeine food

Applies to: Diurex (caffeine / magnesium salicylate)

Information for this minor interaction is available on the professional version.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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